| NPI | 1073849303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 7641-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50078533) |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2025-08-25 |